Journal
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION
Volume 16, Issue 8, Pages 682-689Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jamda.2015.03.010
Keywords
Cognitive function; ankle-brachial index; peripheral artery disease; dementia
Categories
Funding
- National Institutes of Health/National Institute on Aging Cooperative Agreement [UO1 AG22376]
- National Heart, Lung and Blood Institute [3U01AG022376-05A2S]
- Intramural Research Program, National Institute on Aging, NIH [1I01CX000927-01A1]
- Claude D. Pepper Older Americans Independence Centers at the University of Florida [1 P30 AG028740]
- Wake Forest University [1 P30 AG21332]
- Tufts University [1P30AG031679]
- University of Pittsburgh [P30 AG024827]
- Yale University [P30AG021342]
- National Institutes of Health/National Center for Research Resources Clinical and Translational Science Awards at Stanford University [UL1 RR025744]
- Boston Rehabilitation Outcomes Cente [1R24HD065688-01A1]
- National Institute on Aging [K07AG3587]
- Department of Veterans Affairs
- US Department of Agriculture [58-1950-7-707]
- EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH &HUMAN DEVELOPMENT [F32HD006568] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR ADVANCING TRANSLATIONAL SCIENCES [UL1TR001085] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR RESEARCH RESOURCES [UL1RR025744] Funding Source: NIH RePORTER
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [R01HL121023] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [K07AG043587, P30AG024827, P30AG021342, U01AG022376, P30AG031679, P30AG028740, P30AG021332] Funding Source: NIH RePORTER
- Veterans Affairs [I01CX000927] Funding Source: NIH RePORTER
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Objective: The objective of this study was to evaluate cross-sectional and longitudinal associations between ankle-brachial index (ABI) and indicators of cognitive function. Design: Randomized clinical trial (Lifestyle Interventions and Independence for Elders Trial). Setting: Eight US academic centers. Participants: A total of 1601 adults ages 70-89 years, sedentary, without dementia, and with functional limitations. Measurements: Baseline ABI and interviewer-and computer-administered cognitive function assessments were obtained. These assessments were used to compare a physical activity intervention with a health education control. Cognitive function was reassessed 24 months later (interviewer-administered) and 18 or 30 months later (computer-administered) and central adjudication was used to classify individuals as having mild cognitive impairment, probable dementia, or neither. Results: Lower ABI had a modest independent association with poorer cognitive functioning at baseline (partial r = 0.09; P < .001). Although lower baseline ABI was not associated with overall changes in cognitive function test scores, it was associated with higher odds for 2-year progression to a composite of either mild cognitive impairment or probable dementia (odds ratio 2.60 per unit lower ABI; 95% confidence interval 1.06-6.37). Across 2 years, changes in ABI were not associated with changes in cognitive function. Conclusion: In an older cohort sedentary individuals with dementia and with functional limitations, lower baseline ABI was independently correlated with cognitive function and associated with greater 2-year risk for progression to mild cognitive impairment or probable dementia. (C) 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
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